A novel pathway for insurance-based breast reductions: A method for identifying appropriate surgical candidates
Breast reductions are one of the most common plastic surgery procedures performed. The purpose of this study was to streamline the evaluation of patients requiring breast reduction by using a nurse practitioner (NP)-led class to funnel appropriate surgical candidates through the preoperative process...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2023-06, Vol.81, p.132-137 |
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| container_title | Journal of plastic, reconstructive & aesthetic surgery |
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| creator | Hogan, Elise Yalamanchili, Suma Farley, Ellie Guibord, Sarah Beth Strauss, Sarah Gobble, Ryan |
| description | Breast reductions are one of the most common plastic surgery procedures performed. The purpose of this study was to streamline the evaluation of patients requiring breast reduction by using a nurse practitioner (NP)-led class to funnel appropriate surgical candidates through the preoperative process. We performed a retrospective review of patients interested in breast reduction who enrolled in this class from March 2015 to August 2021. Of the 1310 unique patients enrolled in the initial class, 386 patients passed the initial screening and were scheduled with the NP, whereas 924 were screened out at this stage either for being an inadequate surgical candidate or not showing up for clinical visits (36.7%). An additional 185 were screened out after the consultation with NP for reasons such as lack of insurance coverage and no-show visits (20.2%). MD visits had a no-show rate of 7.08%. The decrease in no-show rates between the class-NP visit and the NP-MD visit were both significant (p |
| doi_str_mv | 10.1016/j.bjps.2023.02.022 |
| format | Article |
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[Display omitted]</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2023.02.022</identifier><identifier>PMID: 37141787</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Breast reduction ; Humans ; Insurance ; Insurance Coverage ; Mammaplasty ; Nurse Practitioners ; Referral and Consultation ; Retrospective Studies ; Schnur criteria ; Streamlined surgery ; Surgery</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2023-06, Vol.81, p.132-137</ispartof><rights>2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-93000f14e0e824d725560c4df5130a5cb4ab39bc130f8ba055fd883bd64e8e903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1748681523000815$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37141787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hogan, Elise</creatorcontrib><creatorcontrib>Yalamanchili, Suma</creatorcontrib><creatorcontrib>Farley, Ellie</creatorcontrib><creatorcontrib>Guibord, Sarah Beth</creatorcontrib><creatorcontrib>Strauss, Sarah</creatorcontrib><creatorcontrib>Gobble, Ryan</creatorcontrib><title>A novel pathway for insurance-based breast reductions: A method for identifying appropriate surgical candidates</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Breast reductions are one of the most common plastic surgery procedures performed. The purpose of this study was to streamline the evaluation of patients requiring breast reduction by using a nurse practitioner (NP)-led class to funnel appropriate surgical candidates through the preoperative process. We performed a retrospective review of patients interested in breast reduction who enrolled in this class from March 2015 to August 2021. Of the 1310 unique patients enrolled in the initial class, 386 patients passed the initial screening and were scheduled with the NP, whereas 924 were screened out at this stage either for being an inadequate surgical candidate or not showing up for clinical visits (36.7%). An additional 185 were screened out after the consultation with NP for reasons such as lack of insurance coverage and no-show visits (20.2%). MD visits had a no-show rate of 7.08%. The decrease in no-show rates between the class-NP visit and the NP-MD visit were both significant (p < 0.001). There was no significant difference in gram estimates between providers and pathology (p = 0.5). In total, 171 patients underwent breast reduction (13.05% of the patients screened). The average time from class to surgery was 278.15 days, NP consultation to surgery was 171.48 days, and MD consultation to surgery was 59.51 days. Using a screening pathway allows for early identification of inadequate surgical candidates and therefore streamlines the screening process for optimized breast reduction candidates. Appropriate use of NP visits functions to streamline the funnel, thus decreasing the number of visits and no-show appointments for a surgeon.
[Display omitted]</description><subject>Breast reduction</subject><subject>Humans</subject><subject>Insurance</subject><subject>Insurance Coverage</subject><subject>Mammaplasty</subject><subject>Nurse Practitioners</subject><subject>Referral and Consultation</subject><subject>Retrospective Studies</subject><subject>Schnur criteria</subject><subject>Streamlined surgery</subject><subject>Surgery</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtqHDEQRUWIiR0nP5BF0DKbnpRe3eqQzWDyAoM3zlroUW1r6OnuSGqb-Rt_S74sGsbJMlAgVXHvpeoQ8o7BhgFrP-42brfkDQcuNsBr8RfkgulON6BE_7L-O6mbVjN1Tl7nvAOQgkn1ipyLjknW6e6CLFs6zQ840sWW-0d7oMOcaJzymuzksXE2Y_j95BLaXGjCsPoS5yl_olu6x3I_h5Mh4FTicIjTHbXLkuYlRVuQ1pi76O1IvZ1CDHWU35CzwY4Z3z6_l-Tn1y-3V9-b65tvP662140X0JWmFwAwMImAmsvQcaVa8DIMigmwyjtpneidr92gnQWlhqC1cKGVqLEHcUk-nHLrNr9WzMXsY_Y4jnbCec2GawY9FxzaKuUnqU9zzgkHU9ff23QwDMyRtNmZI2lzJG2A1-LV9P45f3V7DP8sf9FWweeTAOuVDxGTyT5ihRpiQl9MmOP_8v8AXYqRxg</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Hogan, Elise</creator><creator>Yalamanchili, Suma</creator><creator>Farley, Ellie</creator><creator>Guibord, Sarah Beth</creator><creator>Strauss, Sarah</creator><creator>Gobble, Ryan</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202306</creationdate><title>A novel pathway for insurance-based breast reductions: A method for identifying appropriate surgical candidates</title><author>Hogan, Elise ; Yalamanchili, Suma ; Farley, Ellie ; Guibord, Sarah Beth ; Strauss, Sarah ; Gobble, Ryan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-93000f14e0e824d725560c4df5130a5cb4ab39bc130f8ba055fd883bd64e8e903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Breast reduction</topic><topic>Humans</topic><topic>Insurance</topic><topic>Insurance Coverage</topic><topic>Mammaplasty</topic><topic>Nurse Practitioners</topic><topic>Referral and Consultation</topic><topic>Retrospective Studies</topic><topic>Schnur criteria</topic><topic>Streamlined surgery</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hogan, Elise</creatorcontrib><creatorcontrib>Yalamanchili, Suma</creatorcontrib><creatorcontrib>Farley, Ellie</creatorcontrib><creatorcontrib>Guibord, Sarah Beth</creatorcontrib><creatorcontrib>Strauss, Sarah</creatorcontrib><creatorcontrib>Gobble, Ryan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hogan, Elise</au><au>Yalamanchili, Suma</au><au>Farley, Ellie</au><au>Guibord, Sarah Beth</au><au>Strauss, Sarah</au><au>Gobble, Ryan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A novel pathway for insurance-based breast reductions: A method for identifying appropriate surgical candidates</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2023-06</date><risdate>2023</risdate><volume>81</volume><spage>132</spage><epage>137</epage><pages>132-137</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Breast reductions are one of the most common plastic surgery procedures performed. The purpose of this study was to streamline the evaluation of patients requiring breast reduction by using a nurse practitioner (NP)-led class to funnel appropriate surgical candidates through the preoperative process. We performed a retrospective review of patients interested in breast reduction who enrolled in this class from March 2015 to August 2021. Of the 1310 unique patients enrolled in the initial class, 386 patients passed the initial screening and were scheduled with the NP, whereas 924 were screened out at this stage either for being an inadequate surgical candidate or not showing up for clinical visits (36.7%). An additional 185 were screened out after the consultation with NP for reasons such as lack of insurance coverage and no-show visits (20.2%). MD visits had a no-show rate of 7.08%. The decrease in no-show rates between the class-NP visit and the NP-MD visit were both significant (p < 0.001). There was no significant difference in gram estimates between providers and pathology (p = 0.5). In total, 171 patients underwent breast reduction (13.05% of the patients screened). The average time from class to surgery was 278.15 days, NP consultation to surgery was 171.48 days, and MD consultation to surgery was 59.51 days. Using a screening pathway allows for early identification of inadequate surgical candidates and therefore streamlines the screening process for optimized breast reduction candidates. Appropriate use of NP visits functions to streamline the funnel, thus decreasing the number of visits and no-show appointments for a surgeon.
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| fulltext | fulltext |
| identifier | ISSN: 1748-6815 |
| ispartof | Journal of plastic, reconstructive & aesthetic surgery, 2023-06, Vol.81, p.132-137 |
| issn | 1748-6815 1878-0539 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2810923206 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Breast reduction Humans Insurance Insurance Coverage Mammaplasty Nurse Practitioners Referral and Consultation Retrospective Studies Schnur criteria Streamlined surgery Surgery |
| title | A novel pathway for insurance-based breast reductions: A method for identifying appropriate surgical candidates |
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